Exploration of the unmet health care needs of people who inject drugs

Abstract

Background and purpose: Access to adequate health care in the United States is often hindered by an individual's location, socioeconomic status, and lifestyle. Among those underserved are people who inject drugs (PWID), who are affected by stigma and discrimination. The purpose of this study was to describe the utilization of preventative health care services obtained by PWID. Methods: A survey querying participants about their utilization of preventative health care services and health education over the past year was administered to PWID at 2 syringe access programs. Descriptive statistics were used to analyze the data. Conclusion: Of the 141 participants surveyed, 60.6% saw a provider within the past year and 62.1% indicated that their provider was aware of their drug use. Data analysis revealed that providers counseled PWID on three of nine drug-related harm reduction items. Only 30% of PWID talked with their provider about five or more items. Mean number of items discussed was significantly different between PWID whose provider was aware of their drug use and PWID whose provider was unaware of drug use (t = 10.7, p < 0.001). Implications for practice: Results indicated that PWID are not receiving adequate preventative services or harm reduction education from their primary care provider. A need for assessment of substance use, preventative vaccinations, counseling and testing for infectious diseases, and harm reduction education is essential during health care visits. Nurse practitioners and nurses have a role in screening for and educating PWID in a variety of health care settings.

The impact of COVID‐19 on alcohol and other drug nurses' provision of care: A qualitative descriptive study

“…Participants described consumers reporting a decrease in substance use due to availability, and although this was often spoken of as a positive aspect of the pandemic, there were also accounts provided of consumers moving to different substances or overdosing due to reduced tolerance or obtaining drugs of greater purity. These findings emphasise the importance of clinicians, including nurses, providing harm reduction education on tolerance and the risk of overdose, in addition to naloxone (Dion et al, 2020; Mullennix et al, 2020).…”

Healthcare beliefs, health information seeking, and healthcare setting preferences among women who inject drugs by community supervision status

“…A stated preference for the emergency department is noteworthy, given that using the emergency room for usual care is associated with worse patient care experiences, less receipt of high-value clinical care (Levine, Landon, & Linder, 2019), and less continuity of care (Pourat, Davis, Chen, Vrungos, & Kominski, 2015). Among PWID, mental health is the leading reason for emergency room visits (Dion et al, 2020), yet the emergency room mental health treatment is fraught with challenges that result in negative patient experiences, such as a lack of dignity, long wait times, and decreased autonomy (Thomas et al, 2018). Preference for emergency services may result from avoiding preventative and non-emergency medical care, strategies commonly used by PWID to limit exposure to the injection drug use stigma that remains prevalent in healthcare settings (Biancarelli et al, 2019).…”

“…Given that women on community supervision and WWID have significant unmet health needs (Dion et al, 2020;Hawks et al, 2020) and experience significant social vulnerability (Lorvick et al, 2015), understanding how the combined experiences of community supervision and injection drug use influence women's healthcare experiences and service setting preferences can inform how best to intervene with this population. To identify routes for addressing unmet healthcare needs, the present study examined how beliefs about healthcare, health information seeking behaviors, and healthcare setting preferences varied by community supervision status among a sample of WWID in Philadelphia.…”

A Structural Competency Curriculum for Primary Care Providers to Address the Opioid Use Disorder, HIV, and Hepatitis C Syndemic

“…Primary care practices are ideal settings for addressing the syndemic. Evidence shows that many people who inject drugs or are at risk for infectious diseases see their PCPs on a yearly basis but are not engaged in discussions about harm reduction; in many cases, the PCP is not even aware of the patient's risk status (72). Normalizing the management of OUD, HIV, and HCV in the primary care setting can help to reduce the stigma that exacerbates poor health outcomes in the syndemic (13,21,73).…”